13-0392 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description
Property Zoning:
Application valuation:
Applicant:
13-00000392
78027 COBALT CT
604 -023 -046 -
MECHANICAL
MEDIUM DENSITY RES
5823
cht 4 Q" 4 r._, J•K�k
VOICE (760) 777-7012
FAX (760) 777-7011
BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 4/02/13
Owner:
LUSARDI
- 78027 COBALT COURT
LA QUINTA, CA 92253
(
Contractor:
Architect or Engineer: DESERT AIR CONDITIONING, I
590 WILLIAMS ROAD
PALM SPRINGS, CA 92264
(760)323-3383
Lic. No..::276276586
LICENSED CONTRA C R'S DECLARATION
I hereby affirm under penalty of perjury that f am lic sed unde pro isions of Chapter 9 (commencing with
Section 0) of Divi ion 3 of the Business Pr ess nals de a d my Licaa��se� is in full force and effect.
Licenseqls:__ 2 C43 Lice se 0�: 27658ry
l� �/
Date: Contractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
1 1 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and
the structure is not intended or offered for safe (Sec. 7044, Business and Professions Code: The
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
and who does the work himself or herself through his or her own employees, provided that the
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
one year of completion, the owner -builder will have the burden of proving that he or she did not build or
improve for the purpose of sale.).
(_ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
( 1 I am exempt under Sec. , B.&P.C. for this reason
Date: Owner:
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address: ro I e\
LQPERn1IT
D
T`°aD
APR022013
CITY OF LA
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
`7for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
(*/'issued.
ave and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
Code, for the performance of the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier EVEREST NATL Policy Number 7600007908121
I certify that, in the performance of the work for ich'�this permit is issued, I shall not employ any
person in any manner so as to be me s bjec to the workers' compensation laws of California,
andagreethat, if I should becom9 ubj t to a w�fkers' corn nsation provisions of Section
37,Q0 of the Labo�, I snail GI -� or � ith co ly nh t ose pro isions.
Date:1`i11—�/1T1'"/1 Applicant
1
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 1$100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE.LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
conditions and restrictions set forth on this application.
1 . Each person upon whose behalf this application is made, each person at whose request and for
whose benefit work is performed under or pursuant to any permit issued as a result of this application,
the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
of La Quinta, its officers, agents and employees for any act or omission related to the work being
performed under or following issuance of this permit.
2. Any permit issued as a result of this application becomes null and void if work is not commenced
within 180 days from date of issuance of such permit, or cessa 'on of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that the abov f at n i correct. I agree to comply with all
city an+V7;
un di es and state laws relating ding st do , a d hereby authorize representatives
of this f 7pon the above-mentio pro rty f p ctin ose
Date: Signature (Applicant or Agent).
Application Number . . . . . 13-00000392
Permit . . . MECHANICAL
Additional desc .
Permit Fee . . . . 40.50 Plan Check Fee
10.13
Issue Date . . . . Valuation . . . .
0
Expiration Date 9/29/13
Qty Unit Charge Per
Extension
BASE FEE
15.00
.1.00 9.0000 EA MECH FURNACE <=100K
9.00 .
•1.00 16.5000 EA MECH B/C >3-15HP/>100K-500KBTU
16.50
----------------------------------------------------------------------------
Special Notes and Comments
HVAC CHANGE OUT.- 13SEER/7.7HSPF SPLIT
SYSTEM [2008 ENERGY] CARBON MONOXIDE
ALARM(S) TO BE INSTALLED PRIOR TO FINAL
INSPECTION. 2010 CALIFORNIA BUILDING
CODES.
----------------------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged Paid Credited
------------------------------
Due
---------------------------
Permit Fee Total 40.50 .00 .00
40.50
Plan Check Total 10.13 .00 .00
10.13
Other Fee Total 1.00 .00 .00
1.00
Grand Total 51.63 .00 .00
51.63
LQPERAIIT
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CJS}/ 4f %a Quighta
Building 8c Safety Division
P.O. Box 1504,78-495 Calle Tampico
6.Qutnta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Pe t #
Project Address: 78-027 COLBALT CT
Owner's Name:. MARK LASARDI
A P. Number.
Address: 78-027 COLBALT CT
Legal Description:
Contractor. DESERT AIR CONDITIONING, INC
City, ST, Zip: LA QUINTA, CA 92253
Telephone:
Project Description:
Address: 590 WILLIAMS RD
City, ST, Zip: PALM SPRINGS, CA 92264
REPLACE 2.5 TON ELECTRIL SPLIT SYSTEM ON
Telephone: 760-323-3383
GROUND LIKE FOR LIKE
State Lic. # : 276586 City Lie'. #, 363
Arch, Engr., Designer: NA
Address:
City., ST, Zip:
Telephone: s T
State Lic. #: k�
Construction Type. . Occupancy:
project type (circle one): New Add'n Alter Repair Demo
NameofCowAaPerson: JACQUELINE RATLIFF
Sq. Ft.:
# Stories:
#Univ:
Telephone # of Contact Person: 760-323-3383
Estimated Value of project: 5,823.00.
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd
Recd
TRACK NG
PERMIiT FEES-
Plan Sets
Plan Check submitted
Item Amount
Stmdural Cates.
Revlewed, ready for corrections
Plan Check Deposit. .
Truss Cates.
Called Contact Person
Plan Check Balance
Tide 24 Calci.
Plans picked up
Construction
Flood plain plan
Plans resubmitted..
Mechanical
Grading plan
2" Review, ready for correctiooslissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plana picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Gradlug
IN HOUSE:-
''" Review; ready for correctionshme
Developer Impact Fee
Planning Approval.
Called Contact Person
Pub. VVb. Appr
Date of permit issue
School Fees
Total Permit Fees
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -1R -ALT -HVAC
Climate Zones 10 - 15
Site Address: GObwvL'(r
Enforcement Agency:
Date:
Permit #:
78-027 CT La Quinta, CA 92253
City of La Quinta
Mar 25, 2013
Duct insulation
Conditioned Floor
Equipment Type1
List Minimum Efficiency2
requirement
Area
Thermostat
❑ Package Unit
® Furnace
❑ Indoor Coil
❑ AFUE
® SEER 13.0
❑ COP
® HSPF 7.7If
❑ R 6 (CZ 10-13)
Served by system
® Setback
not already present, must be
® Condensing Unit
[3EER
[3 Resistance
[3 R 8 (� 14-15)
1000 sf
installed)
❑ Other
1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -IR -ALT -HVAC for each system.
2. Minimum Equipment Efficiencies: 13 SEER, 78% AFUE, 7.7HSPF for typical residential systems.
HERS VERIFICATION SUMMARY Listed below are FOUR HVAC alteration Options. The installer decides what work is being done
and picks one of the appropriate Options. Each Option lists the HERS measures that must be conducted. A copy of the forms shall
be left on site for final inspection and a copy given to the homeowner. At final, the inspector verifies that the work listed on this
form was in fact the work completed by the installer. The inspector also verifies that each appropriate CF -6R and registered CF -4R
forms (no hand filled CF-4Rs allowed) are filled out and signed.Beginning October 1, 2010, a registered copy of the CF -111
and CF -6R shall also be on site for final inspection.
® 1. HVAC Changeout
Required Forms:
• All HVAC Equipment
CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
replaced
CF -4R forms: MECH-21 and (for split systems) MECH-25
• Condenser Coil and /or
• Indoor Coil and /or
CF -611 forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
• Furnace
CF -4R forms: MECH-21 and (for split systems) MECH-25
For Split Systems: Duct leakage < 15 percent; RC, CCA <_ 300 CFM/ton (Minimum Air Flow Requirement), TMAH
Exempted from duct leakage testing if:
❑ 1. Duct system was documented to have been previously sealed and confirmed through HERS verification, or
❑ 2. Duct systems with less than 40 linear feet in unconditioned space, or
❑ 3. Existing duct systems are constructed, insulated or sealed with asbestos
p 4. The system -will not be Ducted (ie.,Ductiess•Mini-Split System)�(Also Exempt from1Refrigerant,Charge)
❑ 2. New HVAC System
Required Forms:
. Cut inior Changeout with'
`CF 6R forms: MECH-04, MECH-207HERS /and (for, split systems) MECH-22-HERS, and
new ducts: (all new
ducting and all newf�
MECH-,25;
CF -4R forms: MECH-20, and (for split systems) MECH-22, and MECH-25
equipment) j l/
1/ Jr J !l `.
_.!/_
♦ t 7! ._
For Split Systems: Duct leakage < 6 percent; RC, CCA >_ 350 CFM/ton, FWD, TMAH, STMS, and either HSPP or PSPP. "
For Packaged Units: Duct leakage < 6 percent
❑ 3. New Ducts with/or without
Required Forms:
Replacement
. Includes replacing or installing all new
ducting and/or outdoor condensing unit
CF -611 forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS
and/or indoor coil and/or furnace. No or some
CF -4R forms: MECH-20 and (for split systems) MECH-25
equipment changed.
For Split Systems: Duct leakage < 6 percent; RC, CCA >_ 300 CFM/ton, TMAH
For Packaged Units: Duct leakage < 6 percent
❑ 4. New Ducting over 40 feet
Required Forms:
. Includes adding or replacing more than 40
CF -61k forms: MECH-04, MECH-2I-HERS
linear feet of duct in unconditioned space.
CF -4R forms: MECH-21
For split system or packaged units: Duct leakage < 15 percent
❑ EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos.
Contractor (Documentation Author's /Responsible Designer's Declaration Statement)
• I certify that this Certificate of Compliance documentation is accurate and complete.
• I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design Identified on this Certificate of
Compliance.
• I certify that the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the
requirements of Title 24, Parts 1 and 6 of the California Code of Regulations.
• The design features identified on this Certificate of compliance are consistent with the information documented on other applicable compliance
forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with the permit application.
Name: Jacqueline Zabik Signature: Jacqueline Zabik
Company: DESERT AIR CONDITIONING INC Date: Mar 25, 2013
Address: 590 WILLIAMS ROAD License: 276586
City/State/Zip: PALM SPRINGS / CA / 92264 Phone: (760) 323-3383
Reg: 213-A0017923A-000000000-0000 Registration Date/Time: 2013/03/25 18:12:31 HERS Provider: Ca10ERTS, Inc.
2008 Residential Compliance Forms July 2010